Medicare Billing Tips | Don’t Miss the Asymptomatic Individuals for Smoking Tobacco Use Prevention and Cessation Counseling | Use G0436 G0437
Aug30

Medicare Billing Tips | Don’t Miss the Asymptomatic Individuals for Smoking Tobacco Use Prevention and Cessation Counseling | Use G0436 G0437

Don’t Avoid Billing Medicare for Smoking Tobacco Use Prevention and Cessation Counseling for Asymptomatic Individuals Most practice offices knows that effective on and after August 25, 2010, Medicare pays for claims that covers tobacco cessation counseling for outpatient and hospitalized Medicare beneficiaries. This article is focused more on Medicare’s coverage for counseling session to prevent tobacco use for; 1) who use tobacco, regardless of whether they have signs or symptoms of tobacco-related disease; 2) who are competent and alert at the time that counseling is provided; and 3) whose counseling is furnished by a qualified physician or other Medicare-recognized practitioner. These individuals who do not have signs or symptoms of tobacco-related disease will be covered under Medicare Part B when the above conditions of coverage are met, subject to certain frequency and other limitations (see below). The ICD-9 diagnosis codes that should be reported for these individuals are: 305.1 (non-dependent tobacco use disorder) ICD-10 Codes Effective October 01, 2015 F17.200: Nicotine dependence, unspecified, uncomplicated F17.201: Nicotine dependence, unspecified, in remission F17.210: Nicotine dependence, cigarettes, uncomplicated F17.211: Nicotine dependence, cigarettes, in remission F17.220: Nicotine dependence, chewing tobacco, uncomplicated F17.221: Nicotine dependence, chewing tobacco, in remission F17.290: Nicotine dependence, other tobacco product, uncomplicated F17.291: Nicotine dependence, other tobacco product, in remission or V15.82 (history of tobacco use) The ICD-10 Codes Effective October 01, 2015 Z87.891: Personal history of nicotine dependence In 2011, Medicare added two new G codes for billing for tobacco cessation counseling services to prevent tobacco and for asymptomatic individuals use for dates of service on or after January 1, 2011. These are in addition to the two CPT codes 99406 and 99407 that currently are used for tobacco cessation counseling for symptomatic individuals. Use HCPCS Codes to Use: (for Asymtomatic Individuals for Medicare) G0436: Smoking and tobacco cessation counseling visit forthe asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes, G0437: Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes *** FREQUENCY:  It allows 2 cessation counseling session attempts per 12-month period, with maximum of 4 intermediate or intensive sessions per attempt (8 Sessions per 12 Months Period). After eight sessions within the year, additional sessins are allowed only after 11 months since the first covered cessation counseling session. *** WAIVED:  Eligible beneficiaries are covered under Medicare Part B. Both the coinsurance and deductible are waived. CPT Codes to Use for your Symptomatic Patients and for Non-Medicare Payors 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes 99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes “Medicare will...

Read More
Understanding ICD 10 for Medical Practice Offices
Aug26

Understanding ICD 10 for Medical Practice Offices

I will gather as many useful information and website free resources for us to learn more and be awesome for ICD 10! Remember, we have now a final date of October 1, 2015. What is ICD 10? ICD 10 was developed by the World Health Organization (WHO). It is the 10th Revision of the International Classification of Diseases. Many countries are already been using the ICD-10. In the United States, we have the ICD-10-CM for diagnosis coding and will be used in all physicians and health care settings for reporting medical conditions, reason for the encounters, data collection, for payment and reimbursement and all other pertinent purposes. Number of Characters: 3-7 Alphanumeric Characters First Digit is an alpha character (a-z) Second Digit is a numeric character (0-9) Third to Seventh Digit is either alpha or numeric character ICD-10-CM has approximately 68,000 codes while the current ICD-9 has 13,000 codes approximately. So what are ICD 10 Codes? ICD-10-CM Here’s a Figure for the Mapping and how we can easily understand ICD 10 Coding:   ICD 10 Photo Source: jamia.oxfordjournals.org   ICD 10 are very specific codes (so you will be able to code based on its highest specificity) ICD 10 will allow you to accurately code based on: Comorbidities (eg.if there are two or more coexisting conditions in addition to an initial diagnosis) Signs and symptoms Complaints Manifestations Etiology (eg. underlying conditions) Abdormal Findings Complications Social status and circumstances Detailed anatomical site Functional impairment USe of Biological and Chemical Agents Phases and different stages Specific with joint involvement Different involvement of the Lymph Nodes Lateralization (right and/or left) Related to Implants and Surgical Procedures External Causes of injury I can only see advantages on ICD 10 (seriously!) *** If you have a more specific code by description including its lateralization, this may help avoid cross-referencing with other codes; *** And I think with the implementation of ICD 10 CM, tedious claims appeals (due to so many additional information required to establish medical necessity by the insurance payors) can be avoided *** By submitting the most specific diagnosis codes, this can also help maximize reimbursement *** Accurate coding with the highest specificity can also lead to a better, secured and good quality patient care *** The data collection and with specific, accurate coding, research and development in medicine and emerging technologies may improve significantly. *** It can avoid healthcare fraud and abuse My thought of having so many codes?! — it doesn’t mean it would be tougher to find a code, trust me — this will be easier for us to find the most accurate and specific code! Why? – because these codes are presented in its highest and accurate, very specific codes! What...

Read More
ICD 10 Codes Commonly Used for Pain Management, Physical Therapy and Occupational Therapy
Aug26

ICD 10 Codes Commonly Used for Pain Management, Physical Therapy and Occupational Therapy

ICD 10 for 722 Intervertebral Disk Disorders 722.0 M50.20 Other cervical disc displacement, unspecified cervical region M50.21 Other cervical disc displacement, high cervical region M50.22 Other cervical disc displacement, mid-cervical region M50.23 Other cervical disc displacement, cervicothoracic region 722.10 M51.26 Other intervertebral disc displacement, lumbar region M51.27 Other intervertebral disc displacement, lumbosacral region 722.11 M51.24… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

Read More
Medical Billing DME | DMEPOS EXEMPTIONS for Accreditation and Surety | For Physicians, Non-Physicians, Physical Therapist and Occupational Therapists
Aug20

Medical Billing DME | DMEPOS EXEMPTIONS for Accreditation and Surety | For Physicians, Non-Physicians, Physical Therapist and Occupational Therapists

Medical Billing DME I publish this article on my blog because many had been asking me for an answer – “Who are exempted from the DMEPOS from accreditation and/or surety bond?” for medical billing DME This article will focus only on Physicians/Non-Physician Practitioners and PT/OT Services Providers: According to the current guideline, the following are exempted: 1. Physicians 2. Physician Assistants 3. CRNA 4. Registered Nutritionists and Dieticians 5. Certified Midwife 6. Clinicial Social Worker 7. Clinical Psychologist **** But you need to be guided that items are provided and rendered to your own patients as a part of your own services! The Occupational and Physical Therapists are also Exempted from the accreditation process and surety bond only if …. 1. The PT/OT solely own and operates the business office; 2. You provide and rendered the items/services only to your own patients as part of professional services rendered; 3. You can only bill for orthotics, prosthetics and supplies. Additionally, I know that CHIROPRACTORS are NOT exempted from accreditation. Kindly see chart below which I have uploaded from =>> http://www.palmettogba.com/ncs and is last updated August 2009. As far as I know, there are no new changes on this guideline. Should you need help on how to complete a CMS-855s DMEPOS Form for your practice, contact me and I will help you. Read more about the Surety Bond Exemptions here – http://edocket.access.gpo.gov/2009/pdf/E8-30802.pdf Read more about the Accreditation Requirements here – http://www.cms.hhs.gov/MedicareProviderSupEnroll/Do wnloads/DMEPOSAccreditationMIPPA-FactSheet.pdf CMS Form for DMEPOS CMS-855S – Download here! CMS 855s Form for DMEPOS Supplier Application for Medicare   Useful References for DME Billing DME POS PLACE OF SERVICE CODES – https://med.noridianmedicare.com/web/jadme/claims-appeals/claim-submission/pos DMEPOS FEE SCHEDULE – https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Supplier Standards – (please copy and paste the link) http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~National%20Supplier%20Clearinghouse~Supplier%20Enrollment~Standards%20Compliance~DMEPOS%20Supplier%20Standards~7GLS7Z1267 Medicare Enrollment Form for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers – (please copy and paste the link) – https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855s.pdf Medicare Durable Equipment Claims Processing Manual http://www.mspinkymaniri.com/wp-content/uploads/2016/03/Chapter-20-Durable-Medical-Equipment-DMEPOS-Medicare-Claims-Processing-Manual-Rev-3196-02-13-15.pdf If you would like to know on how you can increase revenue in your practice by becoming a DME Medicare Supplier based on the necessity shown above and as long as you provide them as a part of your patients services, CALL ME and I will show you how. Interesting read, CLICK HERE — Why Physicians Medical Practice Cannot Make More Money   Need Immediate Help?  CHAT WITH US/TEXT/CALL  (888) 822-0862 Email: pinky.maniri@gmail.com We Offer CONSULTING SERVICES  We always OVER-DELIVER! 100% Satisfaction Guaranteed. Or we will return your money! We offer hourly coding consulting time on certain specialty only: Pain Management General Surgery Anesthesiology Physical Medicine and Rehabilitation Dermatology Obesity Medicine Sports Medicine Neurology Spine and Orthopedic Surgery Physical...

Read More
How to Bill for BCA Body Composition Analysis for Obesity Services | CPT Code for Body Composition Analysis
Aug19

How to Bill for BCA Body Composition Analysis for Obesity Services | CPT Code for Body Composition Analysis

  “The American Medical Association’s (AMA) recent revision of Current Procedural Technology (CPT) Category III Code 0358T, the code that insurance companies use to recognize Whole Body Composition Analysis tests whose results are generated through a scale called the bioelectric impedance analysis (BIA). Previously, code 0358T had only covered body composition tests that were conducted while a subject tested in the supine position.  A testing period for the revised code will now follow the CPT editorial board’s decision.  The code is scheduled for early release onJuly 1st, 2015, and patients and practitioners can begin contacting their insurance companies for billing options from this date.  Implementation will follow on January 1st, 2016.” So here’s what we need to know, the BCA or the Body Composition code that we can utilize is from the revised Category III code 0358T which will take effect January 1st, 2016 but the providers has to start calling their insurance payors since this code is a CAT III (Contains Temporary Set of Codes) and may not be reimbursable. Source: http://www.inbodyusa.com/blogs/inbodyblog/29243713-inbody-announces-important-revision-to-body-composition-analysis-cpt-code     GOT Question? Connect with me! Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

Read More